左旋门冬酰胺酶在儿童淋巴系统恶性肿瘤化疗中不良反应的监测

Side-effect monitor of L-asparaginase during combined chemotherapy in children with lymphoid malignancies

对20例用左旋门冬酰胺酶(L-ASP)治疗的淋巴系统恶性肿瘤患儿进行治疗前后血Ca、P、PT、KPTT、血糖、血淀粉酶、总蛋白、白蛋白和眼压的前瞻性观察,发现L-ASP治疗后1周较治疗前血Ca、P、总蛋白、白蛋白均有明显降低,1例发生糖尿病,1例治疗后眼压有较明显增高。结论:在L-ASP治疗前后,应对血总蛋白、白蛋白、血Ca、P、血糖做常规监测;对临床有出血倾向者,动态监测PT、KPTT;有腹痛者,动态监测血淀粉酶;有条件者进行眼压测定,有利于及时发现药物不良反应并及时治疗。

To explore a more effect way for the side-effect monitor of L - asparaginase (L-ASP) during combined chemotherapy in children with lymphoid malignancies, serum calcium (Ca), phosphorus (P), PT, KPTT, blood sugar, amy-lase, total protein, albumin and intraocular pressure were determined before and after L-ASP administration in 20 cases with lymphoid malignancies. It was found that serum Ca, P, total protein and albumin decreased significantly at one week after treatment comparing to that before treatment. One case was complicated by diabetes mellitus and another one was found with a higher intraocular pressure. It is suggested that it will be necessary to monitor routinely serum Ca, P, total protein, albumin and blood sugar before and after L-ASP administration. Blood PT and KPTT or blood amylase may be dynamically determined if there is a suspicion of a hemorrhagic tendency or an occurrence of abdominal pain, respectively. The determination of an intraocular pressure will also be recommended if the condition is permitted. It will be possible to detect a side effect of the agent in time and to manage immediately if above measures are carried out clinically.